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Reflux: Common, but Not Normal

In 2006, when I was a year out of residency, I prided myself on the fact that I could manage my pediatric patients’ symptoms—whatever they were—with medications. I did what I had been trained in medical school and wrote prescriptions for laxatives, antihistamines, antibiotics, antacids, and steroids (topical, inhaled, oral, or even sprayed into the nostrils). Sometimes I prescribed two, three, even four medications—all the while convincing the parents (and myself) that this was perfectly safe. 

The day I prescribed an antacid medication to a two-month-old baby I thought to myself, “Sheila, what are you doing?” My gut told me there had to be another way, but I had nothing else in my toolbox to offer this family.

Learn about the transformation in William’s case

Doctors can place babies as young as one month old on antacid medications (proton pump inhibitors,(PPI)), which are the most widely prescribed class of medications in the United States. You have likely seen ads for some of these: Nexium, Prilosec or Prevacid. PPIs account for >$10 billion in annual health care costs 1, and my little patient William (in the video above) had been on one of them for several months before coming to see me.

PPI’s can be a crucial part of treating reflux and healing ulcers, but all too often, patients remain on them much longer than is healthy for the GI tract. Blocking stomach acid hinders the ability to digest and absorb certain nutrients, including B12. PPIs were designed to be used for short periods of time, like six to eight weeks, but often they are taken much longer, and when stopped, cause a rebound effect and more acid is produced, worsening symptoms. My twenty-three-month-old patient William (in the video above) had been on a PPI for several months before coming to see me.

What is Reflux?

Reflux is the backflow of the stomach’s contents into the esophagus and is often the result of lower esophageal sphincter muscle not working in concert with the digestive process. As the sphincter muscle matures, symptoms often diminish or resolve completely. “Benign reflux” can occur in babies and peaks around four months of age and they often outgrown it without the need for intervention.

If reflux goes untreated, acidic gastric juices can damage the lining of the esophagus, causing inflammation and discomfort. Chronic reflux results in gastroesophageal reflux disease (GERD), and long-term GERD can result in Barrett’s Esophagus (BE). BE occurs in older adults and can be a precursor to cancer, therefore, it is important to address reflux. The power of integrative medicine, which I practice, is using the best of both conventional and integrative medicine. 

A complex case that included reflux

William (in the video above) was not gaining weight well and had reflux since infancy when he came to see me before his second birthday. Eventually, he developed chronic intermittent vomiting and was prescribed Nexium, a PPI a year before we started working together. The medication helped, but William’s parents did not want him to stay on it for much longer. 

William also had a history of eczema, which had resolved, and he had eosinophilic esophagitis (this is when there is an increase of allergy-type cells along the esophagus and can also contribute to reflux).

One study showed that when dairy was removed from the diet of babies on an antacid medication, the symptoms improved in 30% of them.2, 3 William’s mom had taken dairy out of her diet when nursing William as an infant, but the reflux persisted. William was already off of most refined sugar, processed foods, and artificial dyes and colors.

Using our Healthy Kids Happy Moms 7-Step Program, we figured out gluten was one of his triggers of reflux. We also gradually started a probiotic, digestive enzyme, and some other key supplements. His symptoms improved significantly, and we eventually weaned him off the Nexium. 

Yes, William had a lot of symptoms besides reflux. His case illustrates how restoring digestive function yields significant, long-lasting improvements. As you see in his before- and after-pictures, William’s symptoms improved along with his coloring, and he started gaining weight like a champ!

I use the same systematic approach in reflux cases more straightforward than William’s. My Program starts with identifying and removing the triggers of inflammation, while supporting digestion and cellular health. The program uses nutrition and targeted nutritional supplements to aid the gut’s healing process. 

Don’t quit a PPI suddenly, and don’t delay action

Learn why antacid medications must be managed and decreased systematically

As I stated above, stopping an antacid medication abruptly can make symptoms worse for your child. My book, Healthy Kids Happy Moms: 7 Steps to Health and Prevent Childhood Illnesses describes how you can gradually shift your diet away from inflammatory foods. I also walk you through how to add the strategic supplements I use to restore digestion in my practice. You can use the information in my book, along with guidance from your pediatrician to begin healing your child’s gut. When your doctor feels it is safe, you can devise a plan to gradually wean off the medication.  

Untreated, reflux can lead to a series of additional health concerns, which is why it is good to be proactive. Look at the graphic below to better understand how antacids create a downstream effect on our digestion and overall health. In my practice we call this phenomenon “The Pharmaceutical March.”

Devised by integrative pharmacist Deb Allen, PRh, the graphic represents the pattern she saw in patients taking PPIs. “Many patients with acid blocker prescriptions returned to the pharmacy six months later with another prescription for depression, anxiety, sleep problems, or focus issues. Without strong stomach acid to activate enzymes that digest and absorb nutrients (such as protein and fat), these patients can’t make adequate amounts of neurotransmitters or hormones.”

Deb’s triplets all suffered from reflux in their preschool years. Working with them to improve their digestion, she weaned them off of antacid medications.

Again, I emphasize the importance of adhering to a two-phase approach to reflux. Start by supporting the body’s ability to digest foods, and only then decrease (or discontinue) antacid medications in consultation with your doctor. 

Takeaway Tips from my Healthy Kids, Happy Moms book and course:

References

https://pubmed.ncbi.nlm.nih.gov/8613639/

https://pubmed.ncbi.nlm.nih.gov/21927657/

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Dr. Kilbane’s approach is universal and can be used by both children and adults who have eczema. Here’s what’s included: